Music is one of the things that's driving up the cost of care. There is a new term called pass-through billing. Today, we have Cheryl McClure, a divisional senior vice-president of healthcare delivery, here to explain it. Pass-through billing can be quite complicated. As you know, we negotiate for the prices we pay to our providers. Some providers negotiate higher prices, while others negotiate lower prices. Sometimes, a provider with a lower price convinces a provider with a higher price to bill on their behalf, even though the higher price provider didn't provide the service. That's what pass-through billing is. Let me make sure I understand this. I could choose to go to a higher-value hospital for a procedure, such as getting a lab test done. The bill would come from the hospital where I had the service, but the payment could actually be from someone else who's using that hospital to bill it, even from another hospital or another state that has nothing to do with the service I received. Is that correct? Yes, that's right. It sounds shady because it allows people to use contracts to take as much money as they can from patients. And unfortunately, sometimes the higher price provider doesn't even have the necessary license to provide the service. There have been legal implications around this as well. I remember hearing about a case where someone had a surgery done, received a bill for pathology services, but there wasn't actually a pathologist working at the hospital. Is that fair? Yes, that's an example of a pass-through billing situation. The shady part is that patients might not find out until they receive their bill or explanation of benefits. So what can a patient do in such cases? If a patient receives an explanation of benefits or bill from a provider they...
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Bcbstx claim Form: What You Should Know
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